Front Matter

62 What is Autism?

The intent of the new guidelines is not to reduce qualifying cases but rather

to capture more reliably everyone who merits ASD diagnosis. DSM‐5 is to be

seen as a “living document,” one that can be altered as fresh information comes

to light, for instance regarding two particular groups that require further study

regarding diagnostic norms: infants and adults.

A New ASD Diagnosis Category: Social Communication Disorder

DSM‐5 introduced an additional diagnostic category called SCD. The intent of the

new category is to include individuals who do not exhibit the repetitive behaviors

or severely restricted interests so characteristic of many individuals with classic

autism, and yet have serious deficits in the area of proper use of language in social

settings. Many children can now receive this ASD diagnosis who previously were

diagnosed with PDD‐NOS, a catch‐all category of individuals who were hard to

diagnose under other categories. Those with a previous diagnosis will likely not be

affected by this new category; basically, only newly diagnosed persons will receive

the newly introduced diagnoses from the latest iteration of the DSM.

ASD or a Giant Spectrum of Socioneuropsychological Disorders

Before we get into the fallacy of ASD primarily being a genetic disease and not the

result of environmental exposure to the fetus, it should be noted that until mid‐1970,

the role of genetics and heritability was not mentioned much in the scientific litera-

ture with regards to autism. Let us first look at how we define ASD today.

ASDs affect three different areas of a child’s life:

● Social interaction

● Communication – both verbal and nonverbal

● Behaviors and interests

This so called phenotypic heterogeneity is the hallmark of ASD and why is

that? If ASD was the result of genetic defects, then there would be a common

denominator(s) by which to diagnose the disorders. We will discuss this very

shortly below.

Each child with an ASD diagnosis will have his or her own pattern of autism.

This is a giant loophole in the definition. This will include many children who

have serious chromosomal rearrangements, additions, and deletions as well as

ones with outright well‐defined genetic diseases. This definition is like trying

to put round pegs into square holes!

This definition may include children who are normal but slightly delayed in

their developmental chart. For example, sometimes, a child’s development is